Are you dreading the prospect of having to stay overnight in a sleep lab? New sleep technology has provided a more convenient and cost-effective option! If you think you have sleep apnea, you need to read this article on how to diagnose sleep apnea at home. Effectively treating sleep apnea can turn your life around!
Finally, A New Way To Diagnose Sleep Apnea!
Traditionally, to diagnose sleep apnea, you spent the night in a sleep lab attached to many cumbersome sensors and machines. This made it very difficult to fall asleep and stay asleep throughout the night. To make matters worse, sleeping pills were avoided because they could interfere with the test outcome. No wonder patients frequently refused to participate in the study!
After all these years of waiting for something easier to come along, it is now possible to do your sleep test at home! A home sleep test (HST) uses a small device that is so easy to set up and attach that you can easily do it in just a few steps.
A home sleep study is best for evaluating obstructive sleep apnea, which is up to ten times more common than the other two types (central and mixed). If your HST shows that you have central or mixed sleep apnea, you may require a follow-up study in a sleep lab. These three types of sleep apnea are explained later in this article.
Home sleep test devices come in three flavors. There is the “traditional prescribed version,” the “online prescribed version,” and the “home consumer version.” In some circumstances, the best way to get the most comprehensive and accurate evaluation for sleep apnea is still by seeing your health care provider, who is familiar with your medical history and has access to excellent pulmonary specialists and testing equipment.
Traditionally-Prescribed Home Sleep Test
This is the most familiar and probably still the most commonly used method. In this model, you are evaluated by your own health care provider, who suspects that your symptoms might be due to sleep apnea. A home sleep study is usually ordered by a pulmonary specialist who reads the results and orders a treatment if required.
Your HST may require preauthorization by your insurance company, and even if it is authorized, you may still be responsible for paying your “deductible” amount. Be sure to clarify what your out-of-pocket cost will be before participating in the study.
Online-Prescribed Home Sleep Test
There are also online companies that allow you to work with their pulmonary physicians to get an evaluation using an online questionnaire followed by a telephone visit. If it is determined that you require testing, then you can purchase an HST device. The pulmonary doctor analyzes the test results, and treatment is prescribed if necessary.
Some companies even sell treatment devices, like CPAP machines. An example of a full-service online company is Lofta.
Do-It-Yourself Home Sleep Test
If you would like to do your own HST, then there are several devices that you can purchase online without the need to be evaluated by a health care provider. The number one device I recommend is the Watchpat Home Sleep Apnea Test Diagnostic Machine. It has 7 discrete channels to measure heart rate, oximetry, actigraphy, body position, chest motion, snoring, and peripheral arterial tone (PAT signal).
How To Do A Home Sleep Test
Home sleep apnea test machines can vary in construction and operation. A popular configuration uses a finger sensor to measure the amount of oxygen in your blood (pulse oximeter), a small mask that fits over your nose to measure the air pressure during inspiration and expiration (nasal pressure), and sensors that measure the movement of your chest and abdomen as you breathe.
Here is a video from the American Academy of Sleep Medicine (AASM) on the basics of a home sleep test.
The Pros And Cons Of A Home Sleep Test
A home sleep test is adequate for the diagnosis of OSA in the majority of cases. It’s a good idea to speak with your health care provider about the most appropriate approach to your particular situation.
- You can perform the test while sleeping in the comfort of your own bed
- The diagnostic equipment is much less cumbersome to wear and fall asleep with
- You will be less likely to have sleep interruptions
- Testing is more convenient without the need for an appointment and travel to a sleep lab
- You typically receive your results quicker
- It can be up to 80% less expensive with a cheaper out-of-pocket expense
- It is more likely to be approved by your health care insurance company than an overnight study in a sleep lab
- Home sleep test results can be less accurate if the sleep pattern and body position are not monitored
- It is currently recommended only for obstructive sleep apnea, not central or mixed sleep apnea
- Not always adequate for people with underlying medical conditions like heart, lung, and neuromuscular disease
- Doesn’t typically test for other related diagnoses like primary snoring
- A suboptimal test result may require a follow up traditional in-lab study
What Is Sleep Apnea?
Sleep apnea is a medical condition that occurs while you sleep. During this time, your breathing becomes erratic and can stop (also known as periods of apnea) for brief periods of time. The abnormal breathing pattern lowers the amount of oxygen in your blood (your oxygen saturation or “O2 Sat”). Over time untreated sleep apnea can cause several serious medical problems.
Who Is At Risk For Sleep Apnea?
If you fit into any of these categories, then you are more likely to have sleep apnea. These risk factors are cumulative, so if you have several, then strongly consider getting a clinical evaluation.
Age – Sleep apnea is more common among 60-year-olds and older
Sex – More common in males than females
Weight – Obese people (BMI greater than 30) have an up to six times higher risk of obstructive sleep apnea
Upper airway abnormalities – These are typically congenital (present at birth) and are more common among Asians
Family history of snoring or OSA – The degree of risk is uncertain, although there is a positive correlation
Smoking – Cigarette smoking may increase the risk of OSA up to 3 times, compared to non-smokers
Chronic nasal congestion – Chronic nasal congestion can double the risk of having OSA
Pregnancy – Although the risk of OSA in pregnancy is not well defined, there is an association
Preexisting Medical conditions – Including hypertension, congestive heart failure (CHF), end-stage kidney disease, type 2 diabetes, gastroesophageal reflux disease (GERD), chronic lung disease (chronic obstructive pulmonary disease or COPD, asthma, and idiopathic pulmonary fibrosis or IPF), transient ischemic attack (TIA) and stroke (CVA), hypothyroidism, Parkinson’s disease, fibromyalgia, and polycystic ovary syndrome
Common Symptoms Of Sleep Apnea
People with sleep apnea may have a variety of symptoms. If you snore with erratic breathing and have any one of the other symptoms in this list, then you should have a clinical evaluation for sleep apnea, especially if you are overweight.
- Snoring, especially when sleeping on your back
- Episodes of erratic breathing or pauses in breathing (apnea), often followed by gasping for air
- Feeling very sleepy throughout the day
- Difficulty concentrating with memory problems
- Changes in mood, such as irritability, anxiety, and depression – See How To Deal With Depression Alone: A Rejuvenating Self-Help Guide
Types Of Sleep Apnea
There are three types of sleep apnea. They all interrupt your breathing pattern and sleep quality.
Obstructive Sleep Apnea (OSA)
Obstructive sleep apnea affects approximately 2 to 9 percent of adults. It is caused by upper airway obstruction, which is most commonly seen in people who are obese (defined as having a body mass index (BMI) of greater than or equal to 30). The fat deposition in the upper airway (mouth, nasal passages, and neck) creates increased airflow resistance.
When you sleep, the muscles in your upper airway and neck relax, which further increases the airflow resistance and makes the obstruction worse. The airway obstruction can cause periods of apnea, especially when sleeping on your back.
There are basically three treatments available to correct the problem.
- The first and best treatment for OSA is weight loss. The majority of obese people that lose enough weight to make their BMI normal (18.5 to less than 25) will have successfully corrected their OSA.
- The second-line treatment is continuous positive airway pressure (CPAP) or bi-level positive airway pressure (BiPAP). These machines, which are used during sleep, move air through the nose and past the upper airway obstruction.
- For people that can’t lose enough weight to correct the problem or tolerate the CPAP or BIPAP, there is a third surgical option to widen the upper airway called Uvulopalatopharyngoplasty (UPPP).
Central Sleep Apnea (CSA)
Central sleep apnea affects less than one percent of adults. It is caused by a problem with your central nervous system. The part of your brain that controls involuntary breathing while you sleep does not send consistent signals to the chest muscles that allow you to breathe in and out (inspiration and expiration).
Central sleep apnea is usually caused by other medical conditions like stroke (CVA) or heart failure (CHF) but can also be caused by medications like narcotics (opioids). It is treated by addressing the underlying medical condition, using supplemental oxygen, or with CPAP or BIPAP.
Mixed Sleep Apnea (MSA)
Mixed sleep apnea is less commonly found than CSA. It is caused by a mix of obstructive and central sleep apnea. It can be caused by any combination of the things that cause OSA and CSA. Treatment is typically tailored toward which type of sleep apnea (OSA or MSA) is more prominent.
Diagnosis And Treatment Of Sleep Apnea Can Avoid Complications!
Diagnosis and treatment of sleep apnea are important to avoid potential long-term complications. Here are some of the complications of untreated sleep apnea.
Neurocognitive dysfunction – Sleep and oxygen deprivation affect the brain’s ability to function properly
Hypertension (high blood pressure) – An elevated blood pressure in the arteries can damage the body’s organs – See Lowering Blood Pressure Naturally – Best Tips And Tricks To Give You Quick Results!
Diabetes (type 2) – The sugar level in the blood is too high, which cause damage to organs of the body
Metabolic syndrome (increased risk of heart disease) – Elevated blood pressure, blood sugar, cholesterol, and waist size
Coronary artery disease (CAD) – Decreased blood circulation that can lead to a heart attack (MI)
Cardiac arrhythmia – Potentially serious abnormalities in the heart’s rhythm, like atrial fibrillation (AFib)
Congestive heart failure (CHF) – The heart contracts less vigorously and begins to fail as a pump
Pulmonary hypertension – The pressure in the lung’s blood circulation is too high, which can damage the lung and heart
Pulmonary Embolism (PE) – A PE is a clot in the lung caused by untreated pulmonary hypertension, among other things
Stroke (CVA) – The blood supply to an area of the brain is cut off, which causes those brain cells to die
Fat deposition in the liver – Fat builds up in the liver, which can lead to cirrhosis and liver failure
Edema – Fluid collects in the legs and other areas as CHF affects the right side of the heart
Polycythemia – The bone marrow makes too many red blood cells to try to correct the low blood oxygen level
Gout – Sleep apnea can make gouty attacks more common
Alternate Strategies And Treatments For Sleep Apnea
Here are some things that have been tried with varying degrees of success to improve sleep apnea symptoms and complications. If you decide to try any of these, I would strongly suggest doing a follow-up sleep study, preferably under your health care provider’s supervision, to be sure that you are correcting the situation.
Add diet and exercise – If you are overweight then diet and exercise are two of the best ways to treat OSA by getting back to your ideal body weight (BMI of 18.5 to less than 25).
Avoid sleeping on your back – Sleeping on your back (in the supine position) can worsen OSA by allowing tissues in your nose and throat (nasopharyngeal area) to be pulled down by gravity and increase the obstruction to airflow in your upper airway. If you are a back sleeper, you can sew a tennis ball onto the back of a shirt to keep you from staying on your back.
If you would like something more comfortable and effective, then the number one solution I recommend is the Side-Sleeping Backpack. It is less likely to wake you up if you turn on your back, like the tennis ball trick. It can be easily customized to your body size by inflating or deflating the airbag.
Try an oral appliance – If you have OSA, then an oral appliance can help splint open your upper airway by repositioning your tongue and jaw while you sleep. Appliances that are available over the counter are not as effective as an appliance custom-made to fit your mouth by your dentist. Before you invest in an expensive customized appliance, check with your health care provider to ensure that you have OSA and that the appliance is your best treatment option.
Nasal strips – Nasal strips splint open your nostrils and may offer some degree of improvement in airway obstruction, especially in combination with other methods, such as an oral appliance. They are more commonly used as an aid to improve snoring.
Embrace meditation and relaxation techniques – Techniques such as mindful meditation, Tai Chi, and yoga can help you get a more restful night’s sleep. Yoga may have a role in improving oxygen exchange by helping to strengthen your upper airway muscles. See Mind Relaxation Techniques – A Healthy Escape From Reality.
Stop smoking and drinking – Smoking and alcohol consumption can create inflammation that leads to swelling and decreased airflow in your upper airway. If you drink alcohol or take sedative medications before sleep, these can increase your upper airway muscle relaxation and worsen your obstruction.
Humidify your bedroom – Sleeping with your mouth open or with dry heat can worsen OSA by drying out your mouth, nose, and upper airway membranes. Humidifying the air in your home, especially your bedroom can help to improve your upper airway obstruction.
Consume dietary supplements – Dietary supplements may help improve sleep apnea. Researchers at MIT found that yohimbine reverses OSA in animals. Other dietary supplements that have been postulated to improve sleep apnea are N-Acetyl-Cysteine (NAC), Coenzyme Q10 (CoQ10), Selenium, Vitamin E, and Vitamin C. See Foods High In Antioxidant – Eating Smart For Better Health
A home sleep test (HST) can be an excellent option for diagnosing obstructive sleep apnea. If you have symptoms and/or risk factors for sleep apnea, then it is important that you make plans to get tested. Deciding what approach is best suited for your own medical and financial situation can be multifactorial.
Purchasing an HST device online without a pulmonary evaluation may be adequate for general screening purposes in people with limited risk factors and symptoms.
If you have significant risk factors, concerning symptoms, or a history of medical problems, then your best option would be doing an HST that is read by a pulmonary specialist. This can be done either online or through your health care provider.
In any event, be sure to take action on properly diagnosing and treating sleep apnea since many of the complications can be permanent and sometimes life-threatening.
Tell Us What You Think
Please let us know what’s on your mind in the comment section, or if I can help you with anything.
- Do you have any additional information to add?
- Have you done a home sleep study? If so, what was your experience?
- Any concerns about doing a home sleep study?